Youth & Young Adult Engagement Advisory (YYEA) Application Form
Please fill out the application form if you wish to become a YYEA member. If you have any issues with the online form, or any questions at all, please email Emily Morrissey EMORRISSEY@YOUTHERA.ORG

*IMPORTANT* - The Children’s System Advisory Council, Oregon Alliance to Prevent Suicide, Healthy Transitions Project and the Youth and Young Adult Engagement Advisory Committee are public entities and it is important that you share information with that in mind. We can talk with you further about any specifics not shared in your application. If you don’t know what this means, get in touch with us ☺
Email address *
Personal Details
Date *
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Full Name *
Your answer
Date of Birth *
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Email *
Your answer
Phone Number *
Your answer
Address *
Your answer
Are you currently enrolled in an educational program? This is not a requirement to be involved. Examples: high school, college, vocational or training program, etc.) *
Your answer
If yes, please answer the following. School Name, Year in School, Major/ Field of Study.
Your answer
Identities (optional)
Race/Ethnicity (can respond with multiple races/identities)
Your answer
Preferred Pronouns (examples: she/her, he/him, they/them)
Your answer
Do you have any other cultural or social identities or experiences you would like to share with us? (examples: LGBTQ+, Indigenous Peoples, Neurodiverse)
Your answer
What services or communities do you identify with? (check all that apply) *
Required
Why are you interested in the Youth and Young Adult Advisory (YYEA) Committee? *
Your answer
Involvement Questions
What skills and/or knowledge would you bring to the YYEA Committee? *
Your answer
What behavioral health* issues do you care about most? Please note that behavioral health includes topics such as mental health and addictions/recovery. *
Your answer
Please check all that you are able to commit to *
Required
1. What types of assistance will you need to participate? Stipends and travel reimbursement are available for all meetings and events. Most meetings and events are held in Salem or Portland, Oregon. In 2020 we will begin hosting additional meetings in Lane and Douglas County for youth who reside in those areas. Advanced notice will be given for all events.
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